Introduction
In 2017, Health Justice Australia had a single member of staff, a three-member board, a fledgling national network and a bold ambition to support health justice partnerships grow to provide better help for people whose legal problems effect their health.
By 2020, Health Justice Australia had a core of nine staff (seven full-time equivalent) and six board members drawn from a diverse range of skillsets and capabilities. Our combined experience spans health, justice and social policy; research, government, non-profit and corporate sectors; from practice in local community services to occupying the highest political offices.
We are supporting a network of around 100 health and legal assistance services collaborating in hospital and community health settings across the country, with interest in this novel way of working continuing to grow. We are sought after as a partner by renowned researchers and research institutions in Australia and overseas; and are influencing government funding, design and delivery at the Federal and state level.
Proving the concept for health justice partnership has laid the foundation for an ambitious agenda for systems change, drawing together new ways of knowing and working to improve health and justice outcomes for people experiencing complex problems and accessing complex systems for support. This is a report of our first four years of activity since our establishment; activity that has informed our Strategy to 2026 and shaped the impact we aim to have.
Building an understanding of the health justice landscape
Undertaking a literature review was our first milestone. This process enabled us to identify what was already known about health justice partnership within the existing literature, and better understand where we could make the greatest difference.
- Our review of existing evaluations of health justice partnerships continues to be updated for the benefit of our network.
- The section on our website dedicated to the value of health justice partnership includes our publications on the evidence and data supporting health justice partnership. This literature review supports our permanent and continuing process to gather, analyse and disseminate knowledge, including through publications, blogs and in the forging of new research relationships.
- Our September 2020 report, Legal help as mental health care, provides another example of how we continually draw on literature to build and translate knowledge to drive systems change and influence decision making.
This early work identified that a lack of clarity about what constitutes health justice partnership as an intervention adds to the challenge of evaluating the impact of this way of working. Our second milestone developed a service model typology that identified features and shared definitions of health justice partnership, a range of other activities on the health justice landscape, and how they differed from existing or ‘status quo’ services. We disseminated this knowledge through our:
- ‘Service models on the health justice landscape: a closer look at partnership’ paper;
- ‘The rationale for health justice partnership: Why service collaborations make sense’
resource for practitioners, researchers and funders; and - workshops at our 2017 and 2019 national conferences
Our third milestone, a process evaluation, provides a framework to understand the activities of health justice partnership, the number of partnerships in operation, and how that number has grown over time. Evaluation findings were published in our two major reports, accompanied by resources to translate and disseminate this knowledge to practitioners, policy-makers, funders and other researchers:
- ‘Mapping a new path’ (2018) and
- ‘Joining the dots’ (2019).
We continue to capture information about partnerships through national and more focussed activities, including:
- ‘Health justice partnership in the time of Covid’, our 2020 survey; and
- Policy engagement such as our recommendations to the next national framework on
domestic and sexual violence.
A shared framework through which to measure health justice partnership outcomes
This fourth milestone provides the foundation for learning (and therefore continuous service improvement), including for impact assessment, across the network. As an emerging and innovative practice, the scope for and definition of impact for health justice partnership is still evolving. Health Justice Australia is co-designing with practitioners and researchers an outcomes framework which identifies the difference health justice partnerships aim to make, for whom and why, recognising how diverse stakeholders benefit from this way of working and identifying core points of shared value.
We have:
- published a growing suite of resources to support the measurement of health justice
- partnership outcomes; and
- attracted international attention, with Health Justice Australia invited to lead the discussion on health justice partnership outcomes measurement in London in February 2020.
We are identifying and testing shared indicators of health justice partnership outcomes and are now
developing tools to implement and measure specific outcomes.
- Indicators are based on a shared theory of change for health justice partnership, that we
- developed in collaboration with the Centre for Social Impact.
- We continue to build the capacity and capability of health justice partnerships to measure
their own outcomes; and - we are partnering on research opportunities to answer questions about the difference that
integrating legal help in health care teams can make in different contexts, for instance children
at risk of adversity.
Monitoring, evaluating and learning from Health Justice Australia’s own impact
Health Justice Australia’s theory of change has evolved over the past four years, as we have built our organisational foundations and identified a clear agenda for systems change that encompasses, but is not limited to, our work with health justice partnerships specifically. Our current theory of change recognises that we have laid the foundations for long-term and sustained impact that we continue to work towards, recognising our role as a centre of excellence provides a unique position to work between services and the systems they operate within, to improve outcomes for the communities they serve.
We see ourselves at year four of a ten-year strategic process and our assessment of impact provided an opportunity to affirm the foundations for our strategic priorities over the next five years. The impact assessment identified that Health Justice Australia has contributed significant value in its first four years, establishing a well-respected organisation while simultaneously bringing rigour and clarity to the health justice model.
Without Health Justice Australia, it was estimated that:
- there would be far fewer health justice partnerships;
- those in existence would have been struggling and isolated;
- Australia would lack a national picture bringing together innovation and learning; and
- there would be little to no funding or policy attention.
The concept of health justice partnership may have ‘withered on the vine’.
We define feasibility and sustainability both in terms of our capacity– reflected in the resources we need – and our capability – reflected in the skills and abilities we need – to achieve our intended impact. The assessment of impact identified the talent of the Health Justice Australia team as our critical asset and we have been developing business models that generate non-grant revenue since 2017. These include:
- Registration income through events and engagement activities;
- Corporate and government sponsorship; and
- Fee for service activities.
We have commissioned independent advice to support our revenue generation from both philanthropic opportunities and business development to resource our activity for impact into the future.
